Impaired clinical response in a patient with uncomplicated falciparum malaria who received poor-quality and underdosed intramuscular artemether

Title
Impaired clinical response in a patient with uncomplicated falciparum malaria who received poor-quality and underdosed intramuscular artemether
Authors
Keoluangkhot, Valy; Green, Michael D.; Nyadong, Leonard; Fernandez, Facundo M.; Mayxay, Mayfong; Newton, Paul N.
Keywords
COUNTERFEIT, ARTESUNATE, QUININE, TRIAL, ANTIMALARIALS, RESISTANCE, DRUGS
Issue Date
2008
Publisher
AMER SOC TROP MED & HYGIENE
Citation
AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE; vol.78 issue 4
Abstract
We describe an adult with uncomplicated Plasmodium falciparum malaria who did not improve clinically despite 5 days of intramuscular artemether therapy. He was prescribed a lower dose (kg body weight) than that recommended, and a vial from the packet contained only 74% of the artemether dose as stated by the manufacturer. The combination of underdosing, poor-quality drug, and the intrinsic low bioavailability of artemether may have contributed to his poor clinical response. Analysis of the packaging and chemical nullfingerprintingnull of the artemether suggested that the drug, was genuine but was either substandard or had deteriorated after manufacture.
URI
http://hdl.handle.net/11267/2211
ISSN
0002-9637
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5.Mahosot Hospital > Journal articles
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